A Rights-Based Approach to Health

A rights-based approach to development uses human rights and their accompanying standards to
analyze and operationalize development programming. In a rights-based approach, development
organizations work with governments and authority figures as well as the population to respect, protect,
and fulfill the development obligations defined in the human rights standards. Four basic principles:
accountability, participation, indivisibility, and non-discrimination form the basis for action in a rights-based
approach.

The Right to Health was established in 1946 in the constitution of the World Health Organization and
reaffirmed in the Universal Declaration of Human Rights in 1948. The right to health is included in over 100
national constitutions.
What is the Right to Health?
In 2000, the UN established human rights standards to define a right to health. These standards are used
to measure the direction of progress towards fulfilling the right to health and are to be realized over time.
Progress towards these standards is the primary responsibility of government officials and authority figures
as well as the population.
The Right to Health Defined
Availability – public health care facilities, goods and “an inclusive right extending not only to
services must exist and be available in sufficient quantity. At timely and appropriate health care but also
a minimum, this includes safe drinking water, adequate to the underlying determinants of health,
sanitation, hospitals and clinics, trained medical personnel such as access to safe and potable water
receiving domestically competitive salaries, and essential and adequate sanitation, an adequate
drugs. supply of safe food, nutrition and housing,
healthy occupation and environmental
conditions, and access to health-related
Accessibility — health care must be physically and education and information…A further
economically available and affordable. It must be provided to important aspect is the participation of the
all on a non-discriminatory basis. Information on how to population in all health-related decision-
obtain services must be freely available. making at the community, national, and
international levels” UN General Comment
Acceptability — all health facilities must be respectful of 14 related to the International Covenant on
medical ethics, and they must be culturally appropriate, Economic, Social, and Cultural
sensitive to gender and life-cycle requirements, as well as Rights(2000)
respect confidentiality.

Quality — health facilities, goods, and services must be scientifically and medically appropriate and of
good quality. At a minimum, this requires skilled medical personnel, scientifically approved and unexpired
drugs and hospital equipment, safe water and adequate nutrition within the facility.

How can the Right to Health be used in Development?

The right to health and the standards for monitoring realization of the right to health provide a basis for
development programming. There are three generally accepted means to using rights in development
programming:

1. A system of analysis:

Use the Right to Health and its standards to assess

• Which standards have been realized, for whom, what is still left to achieve?
• Who is responsible for providing health services and other determinants of health?
2. Operational
• What is beingFramework:
done and by whom to move towards realizing standards?
2. An Operational Framework:

Develop health programs based on human rights principles:

• Equality and Non-Discrimination: Are their differences in health services based on gender,
ethnicity, age, language, religion, birth, or geographic area? Who is doing what to address this?

• Participation: Is the population involved in determining health priorities and in making

community, regional, national, and international decisions about health? What education, analysis,
and capacity building can development organizations provide to facilitate community engagement?

• Accountability: Do governments and authority figures have the responsibility, authority, and
resources to fulfill their responsibilities to ensure health services to the population? What
education, resources, and capacity building can development organizations provide to facilitate
authority figure engagement?

• Indivisibility and Interdependence: Are actions to realize the right to health undermining other
rights? How does work on health contribute to the overall development and poverty eradication
strategy, who is providing these other elements?

3. Advocacy Lens:

Work with human rights organizations and community groups to, for example:
• Ensure that the legal framework for the protection and promotion of the right to health is in place
and respected.
• Monitor progress of government and authority figures towards full realization of the right to
health standards.
• Monitor international structures to ensure that governments and authority figures have the
means and freedom to prioritize protecting, respecting, and fulfilling the right to health.

How does the Right to Health change programming?

Using the human rights standards of the right to health means that development programming is:
• Clearly Targeting Sustainability: By working to ensure that governments and authority figures
assume responsibility for ensuring health services and that communities are directly engaged in
determining the priorities and nature of those services
• Focusing Attention on Poor, Vulnerable, and Disadvantaged Populations: By working to
address imbalances in the current health systems and ensure the equal distribution of health
resources
• Reducing Direct Delivery of Services: In favor of providing capacity building support to
governments and authority figures as well as citizens to negotiate and prioritize actions to improve
health.
• Increasing Work in Partnerships: By identifying local citizen groups and communities as well as
government and authority figures to support as they negotiate and realize human rights standards.

Additional Resources
World Health Organization, “25 Questions and Answers on Health and Human Rights”
http://www.who.int/hhr/activities/en/25_questions_hhr.pdf

American Association for the Advancement of Sciences, “The Right to Health: A Resource Manual for NGOs”
http://shr.aaas.org/Right_to_Health_Manual/index.shtml

For more information on InterAction’s work on a Rights-Based

Approach to Development, visit: www.interaction.org/rba or
contact Patricia MacWilliams, pmacwilliams@interaction.org